Bulletin of Dental Education

By 2030 the number of people 65 years or older in the United States is expected to rise to 72.1 million, according to the U.S. Administration on Aging. This growing segment, which will compose 19% of the U.S. population, will present unique challenges to the next generation of oral care providers.

A pilot program at the University of Alberta Department of Dentistry was implemented in January 2011 to socialize third-year dental hygiene students (the institution’s senior students) to the challenges and rewards of working in long-term care (LTC) facilities. Analysis of the three-month program will determine the most effective protocols for working within a LTC environment, and long-term objectives include contributing to culture change within LTC facilities so that dental hygienists become collaborators in delivery of health care services and are visible on a regular basis.

“The administration has been extremely supportive ... and is interested in discussing how in the future we could involve dentistry students, as we have both groups of undergraduate students in our department,” said Dr. Sharon M. Compton, Professor and Director of the Dental Hygiene Program at the University of Alberta Department of Dentistry.

Five LTC facilities expressed interest in having dental hygiene students provide care to the seniors. The Jasper Place Continuing Care Center and St. Joseph’s Auxiliary Hospital, both in Alberta, Canada, were chosen for their accessibility and ability to ensure in-depth learning experiences.

Though students had experience providing geriatric care in the institution’s on-site dental hygiene clinic and a local rehabilitation hospital, this new practicum was their first experience in a LTC facility. Students were prepped with 10 hours of theory in a classroom setting focused on understanding a geriatric patient.

“Students were somewhat anxious, but I would call it a ‘healthy’ level of anxiety. This was a very new environment for most students,” said Dr. Compton. “Not only from the perspective of the residents themselves and their physical and cognitive challenges, but also to be conducting assessments and providing care in a resident’s room rather than in a traditional-style clinical setting.”

Four students were sent to each site and worked in pairs with a registered dental hygienist who was also a clinical instructor. Students were on site at each of the two locations for one full day per week. Guided by the instructor, students conducted and recorded intra- and extra-oral assessments following Oral Health Assessment Tool (OHAT) protocol and provided instruction on daily mouth care. They also demonstrated daily mouth care to health care aides, who are predominantly responsible for supporting geriatric residents, many with limited dexterity, with their daily routine.

“Anecdotally, students have been very positive about this experience and have commented how this has really helped them to understand the need for improved oral health care in long-term care facilities. Students have also commented how fortunate they felt they were to be able to experience communicating with residents who mostly had early to mild dementia. They have said that having the hands-on experience with people with dementia really helped them to put theory in perspective,” said Dr. Compton.

The three-month rotation ended in April 2011 and is currently undergoing review, but Dr. Compton believes that this inaugural program has the potential to meet an important educational need for dental hygiene students. Components of the pilot program were funded by the Canadian Foundation for Dental Hygiene Research and Education. Dr. Compton will present her findings at the North American Dental Hygiene Research Conference in Bethesda, Maryland, in October 2011.

“I will be meeting with the other three facilities who had previously indicated their interest in having dental hygiene involved at their facility and further strategizing on how we can expand the program to more facilities and provide an even more extensive experience for the dental hygiene students,” she says. “Ultimately, our goal is to provide meaningful and motivating learning experiences that encourage discovery and citizenship.”